Background:Total knee replacement (TKR) is the commonest surgical procedure for patients with severe pain and impaired physical function following end stage knee osteoarthritis. The hip abductors are well renowned in stabilization of the trunk and hip during walking, maintaining the lower limb position, and transferring the forces from the lower limbs to the pelvis.Objective:To assess the efficacy of hip abductor strengthening exercise on functional outcome using performance based outcome measures following total knee replacement.Methods:An observer blinded randomized pilot trial design was conducted at Manipal hospital, Bangalore, India. Participants designated for elective TKR were randomized to experimental group hip abductor strengthening along with standard rehabilitation (n=10) or control group standard rehabilitation alone (n=10). Participants followed for one year to assess physical function using performance based outcomes, such as timed up and go test, single leg stance test, six minute walk test, knee extensor strength and hip abductor strength.Result:Eighteen participants with a mean age of 63.1 ± 5.5 years (8 Males and 10 Females) completed the study. Improvement in hip abduction strength, single leg stand test was superior in hip abductor strengthening group at 3 months and 1 year when compared to standard rehabilitation alone.Conclusion:Hip abductor strengthening showed superior improvements in single leg stance test and six minute walk test. Hip abductor strengthening exercises has the potential to improve physical function following total knee replacement.

Background: Total knee replacement (TKR) is an optimal treatment for persons with severe knee joint pain and disability, who were unsuccessful with conservative management. Early mobilization can be defined as moving out of bed and/or walking quickly after the surgery for reducing the risks allied with bed rest. There is a paucity of studies on effects of early mobilization on a performance-based measure of timed up and go test (TUG), six-minute walk test (SMWT) and a self-reported disease-specific measure of a knee injury and Osteoarthritis outcome score (KOOS) following TKR. Methods: A prospective pre-post-trial was conducted at Manipal Hospital, Bangalore, India. Participants underwent early (POD '0') mobilization on the same postoperative day within 7 h post-TKR surgery. Outcome measures were recorded by an independent blinded observer. The statistical significance level was set at 'p' value < 0.05. The difference between pre-operative and post-operative outcome measure at 1 month and 3 months post-intervention were analyzed using repeated measures of ANOVA. Results: The study included a total of 78 participants (59 Females; 19 Males) and the mean age of the included participants was 64.1 AE 7 years. Amongst, 78 participants, 53 underwent unilateral TKR, 25 underwent bilateral TKR. There were three dropouts in the study due to post-operative complications. Significant improvements from pre-operative to one month were observed following POD '0' mobilization on NPRS (7.35 AE 1.2 to 4.3 AE 1.7), SMWT (169 AE 70 to 236.7 AE 80.7). KOOS subscales of pain, symptom, and quality of life showed significant changes at one month and 3 months. TUG, Knee strength, Knee ROM and KOOS ADL subscale shown improvements only at 3 months post-intervention. Conclusion: Our study findings suggest that POD '0' (early) mobilization can result in reduced pain and an increase in walking speed at 1 month. Significant changes were observed in pain, Knee strength, Knee ROM, TUG, SMWT and KOOS subscales at 3 months following total knee replacement.

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Purpose: The purpose of the study was to find the effects of early rehabilitation on high flex cruciate retaining total knee replacement (TKR) on pain and function. Methods: We designed a prospective pre-post trial and evaluated 34 participants who underwent unilateral TKR following end stage knee osteoarthritis. Outcome measure of numeric pain rating scale (NPRS), knee ROM, quadriceps strength and functional measure of timed up and go test (TUG) and six-minute walk test (SMWT) was assessed before and three months post surgery by a blinded observer. Results: The knee flexion ROM showed significant improvement of 25.1∘[Formula: see text]±[Formula: see text]11.2∘ at 3-months. The NPRS, TUG and SMWT showed significant change of 6.47[Formula: see text]±[Formula: see text]0.92, 21.7[Formula: see text]±[Formula: see text]2.6, 157.7[Formula: see text]±[Formula: see text]31 from baseline to 1.3[Formula: see text]±[Formula: see text]0.8, 17.5[Formula: see text]±[Formula: see text]1.6, 263[Formula: see text]±[Formula: see text]37.9 at 3 months respectively following TKR (p = 0.001). Conclusion: Early rehabilitation showed improvement in knee ROM, pain reduction, and accelerated recovery in performing TUG and SMWT.